CASE OF THE MONTH 04/2021: Hard and soft tissue management in immediate restoration in the esthetic area with partial edentulism

Dr. Massimo Frosecchi:

The clinical case shows the removal of both central incisors due to a fistula and abscesses. As the incisors were supporting a bridge, the bridge between lateral incisors and canines were cut and immediate implant placement for a new 4-unit bridge was planned. A high esthetic outcome was achieved at the final end.

The „Case Of The Month“ highlights every month a clinical case, which distinguished itself by the clinical results or the treatment concept in combination with the applied botiss biomaterials. The selection of the case is based on content relevance and quality of the documentation.

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  1. Dottore Paolino Di Giorgi

    Salve, complimenti per la gestione del caso.Mi pare che siano state usate delle membrane mucoderm,la mia domanda è se queste membrane sono state usate a spessore parziale nella zona dei due incisivi centrali e a spessore totale nei laterali?Se si mi conferma che non c’è nessuna controindicazione ad usare matrici dermiche a spessore totale?Come ha gestito la mancata copertura totale della membrana in alcuni punti? Grazie.

    • Botiss biomaterials

      mucoderm® was used in equal thickness both at the two extraction sites as well as at the two adjacent aspects. Indication-wise there are no restrictions for mucoderm® concerning the thickness, which has a natural variance of 1.2 – 1.7 mm. It can be used in the provided thickness or it can be thinned or cut to shape in all clinical situations indicated for the matrix. Indeed, in this case the matrix was partially left exposed. Studies have shown that mucoderm® can be left exposed to the oral cavity if adequate blood supply by the surrounding tissue is guaranteed. Here, a sufficient area of the matrices were placed under the flap providing optimal conditions for graft integration and remodeling. Thus, no efforts for complete covering of mucoderm® were necessary.

  2. Dottore Paolino Di Giorgi

    Salve,non mi riferivo allo spessore della membrana ma al letto ricevente della stessa. In particolare modo mi chiedo se l’autore ha collocato nel caso da lui riportato il mucoderm sia nel periostio nella zona degli incisivi centrali e nell’osso nella zona degli incisivi laterali. Grazie.

    • Botiss biomaterials

      In the area of the extraction sites, mucoderm® acts as a barrier membrane and was placed between the full thickness flap (i.e. the remaining periosteum) and cerabone® to shield the granules from soft tissue ingrowth. At the placed implants additional soft tissue augmentation was performed by placing mucoderm under the prepared flap, thus the matrix rests between the flap and the residual bone to gain additional peri-implant soft tissue volume.

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